Successful management of a retained host Descemet's membrane after penetrating keratoplasty (PKP)-A case report

被引:0
作者
Albuainain, Abdulrahman [1 ]
Aldofyan, Munirah Z. [2 ]
Otaif, Wael [2 ]
Al-Muammar, Abdulrahman [2 ,3 ]
Alsubki, Haneen [2 ]
Alkatan, Hind M. [2 ,3 ,4 ]
机构
[1] Bahrain Def Force Hosp, Mil Hosp, Eye & Laser Ctr, Royal Med Serv,Mil Hosp, Riffa, Bahrain
[2] King Saud Univ, Coll Med, Dept Ophthalmol, Riyadh, Saudi Arabia
[3] King Saud Univ, King Saud Univ Med City, Riyadh, Saudi Arabia
[4] King Saud Univ, Coll Med, Dept Pathol & Lab Med, Riyadh, Saudi Arabia
来源
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS | 2023年 / 109卷
关键词
Descemet's membrane; Penetrating keratoplasty; Membranectomy; YAG laser; Corneal decompensation; Case report; RETENTION;
D O I
10.1016/j.ijscr.2023.108595
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction and importance: To report the 21st case showing the rare occurrence of retained Descemet's mem -brane (DM) following penetrating keratoplasty (PKP). We intend to investigate possible etiologies, expected sequelae, and outcome of neodymium-dpoed yttrium alumnium garnet (Nd: YAG) laser membranectomy. Case presentation: Our case is a 74-year-old male who underwent PKP surgery in the right eye secondary to corneal decompensation following cataract surgery in addition to corneal thinning secondary to superficial keratectomy related to the pre-existing climatic droplet keratopathy (CDK). Postoperative assessment revealed a retro-corneal membrane within the anterior chamber, which was affecting his vision. Clinical discussion: Based on the post-operative course and the decreased vision as an indication for intervention, it was decided to excise the retained DM. Membranectomy with Nd: YAG laser was performed, and the patient's visual acuity measurement improved from 20/400 to 20/25. However, the endothelial cell count decreased from 1479 to 520 cells/mm(2) (35 % loss) at 15 months post YAG membranectomy with clear graft. Histopathological examination confirmed the clinical suspicion of a retained DM, since it was absent in the submitted host corneal tissue in addition to the pre-existing CDK. Conclusion: Retention of DM following PKP is a rare but possible complication and high index of suspicion is required for proper diagnosis and management to obtain better visual outcome. Nd: YAG laser membranectomy was effective in excising the retained DM and improving vision. Endothelial cell loss following Nd: YAG laser membranectomy as a complication was observed and should be addressed during the treatment plan.
引用
收藏
页数:8
相关论文
共 20 条
[1]   The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines [J].
Agha, Riaz A. ;
Borrelli, Mimi R. ;
Farwana, Reem ;
Koshy, Kiron ;
Fowler, Alexander J. ;
Orgill, Dennis P. ;
Zhu, Hongyi ;
Alsawadi, Abdulrahman ;
Noureldin, Ashraf ;
Rao, Ashwini ;
Enam, Ather ;
Thoma, Achilleas ;
Bashashati, Mohammad ;
Vasudevan, Baskaran ;
Beamish, Andrew ;
Challacombe, Ben ;
De Wilde, Rudy Leon ;
Machado-Aranda, David ;
Laskin, Daniel ;
Muzumdar, Dattatraya ;
D'cruz, Anil ;
Manning, Todd ;
Healy, Donagh ;
Pagano, Duilio ;
Goel, Prabudh ;
Ranganathan, Priya ;
Pai, Prathamesh S. ;
Raja, Shahzad ;
Athe, M. Hammad ;
Kadioazlu, Huseyin ;
Nixon, Iain ;
Mukherjee, Indraneil ;
Gomez Riva, Juan ;
Raveendran, Kandiah ;
Derbyshire, Laura ;
Valmasoni, Michele ;
Chalkoo, Mushtaq ;
Raison, Nicholas ;
Muensterer, Oliver ;
Bradley, Patrick ;
Roberto, Coppola ;
Afifi, Raafat ;
Rosin, David ;
Klappenbach, Roberto ;
Wynn, Rolf ;
Giordano, Salvatore ;
Basu, Somprakas ;
Surani, Salim ;
Suman, Paritosh ;
Thorat, Mangesh .
INTERNATIONAL JOURNAL OF SURGERY, 2018, 60 :132-136
[2]  
Arenas Archila E, 1993, Refract Corneal Surg, V9, P65
[3]   Predicted Long-term Outcome of Corneal Transplantation [J].
Borderie, Vincent M. ;
Boelle, Pierre-Yves ;
Touzeau, Olivier ;
Allouch, Cecile ;
Boutboul, Sandrine ;
Laroche, Laurent .
OPHTHALMOLOGY, 2009, 116 (12) :2354-2360
[4]   DISLOCATION OF DESCEMETS MEMBRANE DURING KERATOPLASTY [J].
BROWN, SI ;
DOHLMAN, CH ;
BORUCHOFF, SA .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 1965, 60 (01) :43-+
[5]   Retained Descemet's membrane after penetrating keratoplasty [J].
Chen, YP ;
Lai, PCC ;
Chen, PYF ;
Lin, KK ;
Hsiao, CH .
JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 2003, 29 (09) :1842-1844
[6]   A case of corneal endothelial deterioration associated with retained Descemet's membrane after penetrating keratoplasty [J].
Choi, Jin Seok ;
Oh, Joo Youn ;
Wee, Won Ryang .
JAPANESE JOURNAL OF OPHTHALMOLOGY, 2009, 53 (06) :653-655
[7]   Double Descemet's membranes after penetrating keratoplasty with anterior segment optical coherence tomography [J].
Ide, Takeshi ;
Yoo, Sonia H. ;
Kymionis, George D. ;
Shah, Pulin A. ;
O'Brien, Terrence P. .
OPHTHALMIC SURGERY LASERS & IMAGING, 2008, 39 (05) :422-425
[8]   Corneal endothelial cell changes twenty years after penetrating keratoplasty [J].
Inoue, K ;
Kimura, C ;
Amano, S ;
Oshika, T ;
Tsuru, T .
JAPANESE JOURNAL OF OPHTHALMOLOGY, 2002, 46 (02) :189-192
[9]  
Kremer Israel, 2012, Ophthalmic Surg Lasers Imaging, V43 Online, pe94, DOI 10.3928/15428877-20120906-03
[10]   Corneal endothelium after deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus: A four-year comparative study [J].
Kubaloglu, Anil ;
Koytak, Arif ;
Sari, Esin Sogutlu ;
Akyol, Sibel ;
Kurnaz, Ekrem ;
Ozerturk, Yusuf .
INDIAN JOURNAL OF OPHTHALMOLOGY, 2012, 60 (01) :35-U1